Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostaglandin E1 has a strong vasodilator effect, it inhibits the aggregation of platelets and improves the microcirculation. The hormone is synthesized from arachidonic acid and 80-90 per cent is eliminated in the first transit of the pulmonary circulation. From 1 January 1978 to 30 June 1981 100 patients suffering from inoperable occlusion of the arteries of the lower limbs and facing amputation were treated with intra-arterial PGE1 by prolonged perfusion over an average period of 34 days. PGE1 0.1-0.2 ng kg-1 body weight min-1 was administered. Forty-seven of 100 legs were saved; 22 of 29 patients suffering from diabetes requiring insulin had to undergo amputation, but only 1 of 18 patients suffering from thromboangiitis obliterans had to have an amputation. The results of treatment in the 52 cases of uncomplicated arteriosclerosis lie in between, with 18 amputations. The complications that followed treatment were haemorrhage, arterial thrombosis, infection and mycotic aneurysms.
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PMID:Conservative treatment of inoperable arterial occlusions of the lower extremities with intra-arterial prostaglandin E1. 704 65

Continuous subcutaneous insulin infusion (CSII) is one of the ways to control blood glucose for prolonged periods. This study was undertaken to establish the long-term feasibility and efficacy of CSII with patient self-management. Patients were instructed to maintain their calorie and carbohydrate intake. Basal infusion of insulin, representing 50% of the total pre-CSII dose, was supplemented by boluses of insulin based on carbohydrate intake for each meal. With this type of regimen, blood glucose and M-values were easily normalized during the physician-directed periods. This study demonstrated that near-normalization of blood glucose, M-values, and glycosylated hemoglobin was maintained after a 1 1/2-yr period of patient self-management. We attributed this successful management in part to the protocol used, in which boluses were related solely to carbohydrate intake while basal insulin was adjusted according to fasting blood glucose. The chronic normalization of blood glucose resulted in improvement of platelet function as witnessed by responsiveness to antiaggregating (PGE1) and aggregating (epinephrine) agents. An improvement was noticed in doppler measurement of ankle-arm blood pressure and a near-normalization of nerve latency and conductivity was observed.
Diabetes Care
PMID:Patient self-management of continuous subcutaneous insulin infusion. 718 34

One hundred and fifty-nine men with erectile dysfunction were assessed with Rigiscan monitoring of nocturnal penile tumescence (NPT) and response to intracavernosal injections (ICI) of papaverine or prostaglandin E1. A satisfactory NPT, suggestive of psychogenic causation, was recorded in 58%, whereas 15% had clearly impaired NPT. There was a significant association between presence of vascular disease, diabetes and impairment of NPT. For ICI, only 32% showed a satisfactory response, with 48% clearly impaired. Of the 92 men with satisfactory NPT, 40% HAD clearly impaired and 41% satisfactory ICI response. Of the 51 men with satisfactory ICI response, 8% had clearly impaired and 74.5% satisfactory NPT. There was no association between ICI response and history of vascular disease. We conclude that monitoring of NPT by Rigiscan, and without sleep monitoring, is a valuable diagnostic procedure. In contrast, because of the high proportion of false negative results. ICI monitoring is of very limited diagnostic value. The explanation for false negative ICI responses, however, could prove to be of considerable theoretical and clinical importance.
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PMID:The clinical assessment of erectile dysfunction: a comparison of nocturnal penile tumescence monitoring and intracavernosal injections. 749 41

The single potential analysis of cavernous electric activity (CC-EMG), registration bands were studied in 144 patients with erectile dysfunction followed from November 1992 to March 1993. We attempted to correlate abnormal electromyographic records with reduction of the cavernous bodies and albuginea expansibility, as measured by cavernosometry/rigidometry. In this selected group of patients, with venous leak of different flow, the main associated causes of the erectile dysfunction were cavernous neuromyopathy (91), diabetes mellitus (20), disturbances of the arterial influx (7), endocrinological factors (4), Peyronie's disease (3). Some patients (15) presented with a penile bend. A history of alcohol and tobacco use was obtained: 38 patients smoked 15 to 60 cigarettes/day and 43 patients drank moderate to heavy. The coexistence of other pathologies, has been investigated, showed many other associated diseases. The study attempts to determine if some electromyographic standards in patients with erectile dysfunction, could, by themselves, be a formal indication to penile implant, for a PGE1 self-injection program or for use of a vacuum device. Our results suggest that at least in some cases CC-EMG studies may be clinically relevant and allow choice of optimal therapy.
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PMID:The corpus cavernous electromyography in the erectile dysfunction diagnosis. 761 75

Mortality and morbidity from coronary heart disease (CHD), diabetes mellitus (DM) and essential hypertension (HTN) are higher in people of South Asian descent than in other groups. There is evidence to believe that essential fatty acids (EFAs) and their metabolites may have a role in the pathobiology of CHD, DM and HTN. Fatty acid analysis of the plasma phospholipid fraction revealed that in CHD the levels of gamma-linolenic acid (GLA), arachidonic acid (AA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are low, in patients with HTN linoleic acid (LA) and AA are low, and in patients with non-insulin dependent diabetes mellitus (NIDDM) and diabetic nephropathy the levels of dihomo-gamma-linolenic acid (DGLA), AA, alpha-linolenic acid (ALA) and DHA are low, all compared to normal controls. These results are interesting since DGLA, AA and EPA form precursors to prostaglandin E1, (PGE1), prostacyclin (PGI2), and PGI3, which are potent platelet anti-aggregators and vasodilators and can prevent thrombosis and atherosclerosis. Further, the levels of lipid peroxides were found to be high in patients with CHD, HTN, NIDDM and diabetic nephropathy. These results suggest that increased formation of lipid peroxides and an alteration in the metabolism of EFAs are closely associated with CHD, HTN and NIDDM in Indians.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Essential fatty acid metabolism in patients with essential hypertension, diabetes mellitus and coronary heart disease. 764 60

Insulin treatment of platelets is associated with increased prostaglandin E1-stimulated adenylyl cyclase activity and decreased platelet aggregation. Because non-insulin dependent (Type II) diabetes mellitus is associated with hyperinsulinemia, we sought to determine the effect of insulin treatment in vivo and in vitro upon stimulation of platelet adenylyl cyclase by prostaglandin E1. Incubation of platelet-rich plasma obtained from normal subjects with 2 microM prostaglandin E1 resulted in a 16-fold increase in cAMP accumulation. Pre-incubation of platelet-rich plasma with 0.7 nM insulin resulted in a 62% increase in prostaglandin E1 (2 microM)-stimulated cAMP accumulation (p < 0.005). Pretreatment of platelets with cholera toxin prior to incubation with insulin had no effect on subsequent prostaglandin E1-stimulated cAMP accumulation. By contrast, pretreatment of platelets with pertussis toxin prior to incubation with insulin resulted in a nearly 2-fold increase in prostaglandin E1-stimulated cAMP accumulation (p < 0.005). To determine whether platelets exposed in vivo to elevated concentrations of insulin would show similar responses, we isolated platelet-rich plasma from subjects before and after a 120 minute euglycemic clamp study in which insulin was infused (40 mU m-2min-1) intravenously. Patients who underwent the euglycemic clamp study achieved steady state serum levels on insulin of 0.70 +/- 0.19 pmol/ml. Platelets obtained after insulin infusion had a 65% increase in prostaglandin E1-stimulated cAMP. Our results indicate that serum levels of insulin that are common in patients with type II diabetes mellitus can increase the sensitivity of platelet adenylyl cyclase to stimulation by prostaglandin E1.
Diabetes Res 1994
PMID:The effects of in vitro and in vivo exposure to insulin upon prostaglandin E1 stimulation of platelet adenylate cyclase activity in healthy subjects. 764 95

Prostaglandins of the E series (PGE) are known to contribute to the maintenance of renal hemodynamics in subjects with chronic renal insufficiency. Agents that block PGE synthesis, nonsteroidal anti-inflammatory agents (NSAID), are widely used by people with renal insufficiency. This study was undertaken in subjects with renal insufficiency secondary to diabetes to evaluate the acute effects of a PGE1 analog, misoprostol, on NSAID-induced changes in RBF, as calculated by para-aminohippurate clearance, and GFR, as calculated by inulin clearance. Sodium excretion was also assessed. Twenty-five fasting subjects with a mean age of 56 +/- 4 yr received 800 mg of ibuprofen orally. A concomitant dose of either a placebo (PL) or 200 micrograms of misoprostol was also given. This was followed in 1 h by either a placebo or an additional 200-micrograms dose of misoprostol. Measurements for the determination of RBF, GFR, blood pressure, and fractional excretion of sodium were performed every 30 min for the next 5 h. The greatest reduction in both GFR (-25 +/- 7 mL/min per 1.73 m2 PL versus -10 +/- 4 mL/min per 1.73 m2, misoprostol delta GFR; P < 0.05) and RBF (-48 +/- 21 mL/min per 1.73 m2 PL versus -15 +/- 8 mL/min per 1.73 m2, M delta RBF; P < 0.05) occurred approximately 2 h after the NSAID dose. No significant differences were noted in blood pressure, fractional excretion of sodium, or other measured parameters between groups during the entire study. Gastrointestinal upset was the most common side effect observed in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal effects of oral prostaglandin supplementation after ibuprofen in diabetic subjects: a double-blind, placebo-controlled, multicenter trial. 778 57

Erectile failure, although a common problem in male diabetic patients, is one of the most neglected complications of diabetes. The availability of drugs like alprostadil (prostaglandin E1; PGE1) and papaverine for intracavernosal injection and the development of vacuum tumescence devices, while making therapy simple, have also reduced the necessity for specialised investigations. In the past 10 years, alprostadil has been shown to be the safest and the most effective of the intracavernosal self-injection treatments of erectile dysfunction. Vacuum tumescence devices are an acceptable noninvasive alternative in those who fail to achieve a satisfactory response to self-injection. Surgical techniques are being improved every day, and revascularisation procedures and prosthetic implants are available to couples in specialised centres. At present, systemic drug therapy has been largely ineffective for treatment in diabetic patients but progress is being made in this field. Whatever the option, involvement of the partner in decision making is of major importance for the treatment to be successful, and psychosexual counselling is a useful adjunct to medical or surgical therapy.
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PMID:Optimal treatment of erectile failure in patients with diabetes. 778 88

The aim of the study was to investigate whether oral application of misoprostol (MI), which is an analogue of prostaglandin E1, does change the secretion of insulin and the blood glucose level. The investigations were carried out in 15 subjects, aged 21-40 yrs, with a gastric or duodenal ulcer and without any disturbances of the digestive tract motility. In 7 of them (group A), without stated diabetes a single oral dose of 400 mg MI versus placebo (PL) and 15 min later 75 g glucose p.o., was applied in randomized order, on different days, in fasting state. In 8 subjects with mild diabetes type II (gr B) MI versus PL and after 15 min. i.v. 1.0 mg glucagon was similarly administered. In both groups the concentrations of glucose and C-peptide in blood were determined. In comparison to PL, the application of MI did not cause any statistically significant differences of C-peptide in serum and blood glucose levels neither before and after oral glucose loading nor after i.v. administration of glucagon. Statistically not significant were also the differences in AUC (p > 0.05).
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PMID:[Effect of misoprostol, a synthetic prostaglandin E analog, on levels of serum C-peptide in serum and glucose tolerance]. 780 May 81

Prostaglandin E1 (PGE1) is widely used for the treatment of impotence. We retrospectively studied 322 patients who had received injection of prostaglandin E1 from 1991 to 1993 and attempted to divide them into different subgroups as a function of the aetiology of the impotence in order to determine whether there is a difference in efficacy and tolerance. The complete work up included at least two consultations with a sex therapist, a pharmaco-Doppler examination, cavernometry, plethysmography of the nocturnal erections and blood chemistry with assay of the free testosterone in all patients. Erections compatible with penetration were observed after prostaglandin E1 injection in 85.4% of the patients (all aetiologies). Very favourable results were obtained in the group of patients with an arterial defect (n =36) since erections allowing intercourse were obtained in 83.3%. For the patients with occlusive venous dysfunction (cavernous leakage) (n = 35) the injections were less effective but led to satisfactory results in 74.3%. The results were excellent (94.7%) in the cases of psychogenic impotence (n = 113). Finally, in patients with diabetes related impotence (n = 21), the treatment was much less effective giving only 52.3% of positive results. In several cases (n = 151) we were able to compare the effectiveness of PGE1 with that of papaverine alpha blockers. For the patients with an arterial defect, PGE1 was slightly more effective. For patients with an occlusive venous dysfunction, PGE1 was always more effective than papaverine and finally, for patients with diabetes, the papaverine-alpha blocker combination was more effective than PGE1 in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prostaglandin E1 in the treatment of erectile insufficiency. Comparison of efficacy and tolerance based on different etiologies]. 791 73


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